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Question: Recently one of our providers was in the news and reporters called our office. We all refused to comment when contacted. That seemed the safest course, but now we’re wondering if we ... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Billing practitioners who do not treat patients during a procedure’s full global period are slightly more likely to report claims with surgical care-only modifier 54 than with postoperative ca... More

Ask a Part B News Expert

Question: Recently one of our providers was in the news and reporters called our office. We all refused to comment when contacted. That seemed the safest course, but now we’re wondering if we ... More

NPP Report

Recent changes mandated by Congress and CMS that boost the status of physician assistants (PA) — or physician associates, as some groups prefer — is another sign that the providers formerl... More

Benchmark of the Week

Billing practitioners who do not treat patients during a procedure’s full global period are slightly more likely to report claims with surgical care-only modifier 54 than with postoperative ca... More

Prepare for 2025 success with coding, billing and compliance virtual events

by: Richard Scott

Breaking: Part B fees under fire, as CMS redesigns policy, coverage rules in proposed 2025 PFS

by: DecisionHealth Staff

Sneak preview: 4 highlights from the proposed 2025 Medicare physician fee schedule

by: Julia Kyles, CPC

Train your team with the complete ICD-10-CM code set

Prepare members of your treatment and coding teams for changes to the diagnosis code set that will go into effect Oct. 1, 2024. Download and share the Excel file that contains five spreadsheets.

Give providers an illustrated guide to the new SDOH risk assessment code

Make sure your physicians and qualified health care professionals (QHP) are ready for their crucial role in reporting G0136 (Administration of a standardized, evidence-based Social Determinants of Health [SDOH] Risk Assessment tool, 5-15 minutes, not more often than every 6 months).

Surgical, postop-only claims almost even for transfer of care cases

Billing practitioners who do not treat patients during a procedure’s full global period are slightly more likely to report claims with surgical care-only modifier 54 than with postoperative care modifier 55, according to Medicare Part B claims data.

Modifier 78 continues its slide, though most codes have 0% denials

The Medicare billing numbers show a precipitous pandemic-era drop in utilization of modifier 78 (Unplanned return to the operating room by the same physician following initial procedure for a related procedure during the postoperative period). You may have expected that losing trend to slow as America began to recover from the pandemic in 2022. It did, but not by much. The total number of 78 citations slid from 65,857 in 2021 to 51,177 in 2022, a 22% loss.

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Advanced Specialty Coding Virtual Summit: Pain Management

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